About The Book

When I started thinking about writing this book, “it’s a commitment” were the first words that came to mind. When you think about it, you wouldn’t be considering, or be scheduled for, major surgery if you weren’t committed to living a better quality of life. Surgery is a frightening prospect. Many people allow their fear to overcome their desire to live free from chronic pain and they never make the call to their health care provider to find a way out of their unhealthy and painful situation. Increasingly, medical professionals, insurance carriers and medical devices companies are working to better inform prospective patients about the path to a healthy life free of pain. The Optimized Patient is both a guidebook on how to prepare for and recover from surgery and the gateway to a community of people who, like you, have made a commitment to get well and live a pain free life. Although my personal experience with crippling pain was associated with spine surgery, the Optimized Patient is an important resource for anyone and everyone who is considering or scheduled for major surgery…

Imagine that you are at a dinner party and six people who have successfully recovered from major spine surgery are gathered at a large table. Three neurosurgeons, two physical therapists and a chiropractor just sat down to join them in a discussion about how to optimize for spine surgery. To top it off a Ph.D who is a Registered Dietician Nutritionist (RDN) just showed up to share how food plays a major role in optimizing for and recovering from surgery. Now imagine that they are gathered in this room just to help you understand if surgery is right for you. Well, that’s exactly where you’re sitting …

We all come to sit in the surgeon’s office for the same reason; we hurt and have lost our quality of life. How we got to the place of chronic pain, however, runs the gamut from falling off a mountain to falling on a basketball court. You have already met the five other patients besides me. Now, let’s dig more deeply into their stories. I’m pretty sure you will find yourself saying, “Yeah, that’s what happened to me”. I know that’s what I was thinking when I interviewed them. There’s a seventh patient who I am saving to the end of the book. He is a screenwriter friend of mine named Adam Rodman. Adam did not have spine surgery, but he did follow the Optimized Patient strategy. His surgery was to correct damage done to his septum and sinuses when he was a young man. Adam had a tendency to use his face to stop the fists of his high school classmates with whom he had intellectual disagreements. If I remember correctly it had something to do with him being the only Jewish kid in a Catholic boys school…

This might be your favorite chapter. The conversation is moving on from talking about what happened to what did we did about it. Like the many different causes of back pain, we all tried many different options before we made the trip to see the spine doctor. You may be luckier than any one of us and not need spine surgery at all. But, how do you know if you do or if you don’t? There are many options from aqua therapy to chiropractic to epidurals. This is the twilight zone for back pain that most people know little or nothing about. If you are researching alternatives to surgery on the Internet, be warned. Much of what you will find on Google is 5% information and 95% marketing. The patients and doctors who are sharing their experiences in this book have a lot to say about whether or not they found realistic and viable options in lieu of spine surgery. The good news about their comments and information; no marketing. They have nothing to sell. The only thing they have to offer are insights and options…

You’ve heard the facts behind the horror stories and having weighed the pros and cons of spine surgery, you have decided to put an end to your chronic pain. But, are you a good candidate for spine surgery in the first place? As we are learning, just because your back hurts doesn’t mean you need or should have spine surgery. The most interesting part of the conversation that follows is that you and your surgeon you are actually a team working to achieve the same goal; to relieve your suffering and help you to become you again. When I first started thinking about how to be an optimized patient I only looked at it from the patient’s point of view. During the interviews, I found out that the surgeon’s considered both sides of the equation. There is a surgical outcome and there is a clinical outcome. Simply, there is the surgeons’ job and, according to them, then there’s the patient’s job. There is a lot to learn about what makes an optimized patient from the surgeon’s perspective.

The more precise question is, what will it take to get well, to be me again? Very few people, other than medical professionals, even understand how human beings get better. Is it the cast that heals your arm or is it your arm that heals your arm? Right, your body is programmed to heal. You don’t really have to think your body into healing a wound or clearing up a bruise, it just does it; when the conditions are right. Most patients approaching spine surgery feel that the surgeon is going to do the work and you are just along for the ride. My body is going to do what my body is programmed to do, right? Well, kinda. As we heard in the “Surgeon’s Perspective” there is a surgical outcome and a clinical outcome. The clinical outcome is the one in your control. Helping your body to fully recover pain-free function is the very definition of a clinical success and the reason why anyone preparing for spine surgery should know how to optimize.

There is great comfort in replacing fear with facts. For me, having spine surgery was like going to a foreign country. There was a whole new language to learn and a lot of very unfamiliar territory. If you have ever planned a trip overseas, you know the general process of preparing to experience something entirely different. I have to admit, I am a lot better at planning trips and knowing what I want to do before traveling than I was at planning for surgery and the subsequent recovery. I know how to travel. I knew nothing about my spine before my first surgery. True to the travel analogy, the second surgery and the third were a lot less challenging because I had already learned the language and the custom. With the new knowledge gained from my first surgery I recall thinking as I prepared for my second surgery, “Shouldn’t I …? Why didn’t we … ? Wouldn’t it be better if we  … “ Knowing what to ask before your surgery is key to the optimized patient strategy…

In order to understand how to navigate your rehabilitation, let’s review where the surgeon’s job begins and where it ends. There is a medical answer and philosophical answer to this question. The medical answer flows from understanding the difference between the surgical and clinical aspects of back surgery. In that context, the surgeon’s job ends when you are sewn-up in the operating room. How involved your surgeon is after that will be determined by how much surgically related care is needed; like removing drains and monitoring your wound and vitals. Philosophically, patients believe surgeons are going to manage them from soup to nuts. That’s a charming idea, but it is not how your recovery process works. More importantly, it’s not how the recovery process should work. Rehabilitation is a highly specialized episode in the back surgery story and is best left to professionals trained in rehab techniques and technology. The next three chapters cover activity, mindset and nutrition. Each one of those areas are important enough, and complex enough, to warrant their own chapter; they are all part of rehab. Implementing what I share with you here is where your full recovery is either won or lost…

Let’s take a deeper dive into “it’s a commitment” and “mindset”. If you are reading this book end to end, you know that education, prehab, rehab and mindset are all part of the recipe for a full recovery. Knowing what needs to be done and getting it done are two very different things. I had two goals; to be out of pain and to be able to walk without a limp. Both of those goals seemed impossible to get. Between panhandlers at Starbucks and airport skycaps I was in a daily experience of being asked if I was alright or needed assistance?  For a while, I felt pretty sorry for myself and then I met Noah Galloway[1]. Noah and I were both guests on the Home and Family Show on the Hallmark Channel. I was talking about financial matters, and Noah was talking about how he decided to live a full life even though he had lost an arm and a leg in military service. I knew how hard I struggled with pain and mobility challenges. I told him about my injuries and shared with him that I could not begin to imagine what he went though. In response, Noah, without even trying, gave me a priceless mindset shift. He told me he had been depressed for many years after he was injured. It’s part of what he talks about on speaking tours. Noah shared that he simply made a choice to stop feeling sorry for himself and start doing what he needed to do to get better. Noah knew that the journey to getting his life back had to begin with the will to get well.

[1] noahgalloway.com/

Does it make sense to you that fresh fruits and vegetables are better for you than frozen dinners and fast food? Do you need a scientific double blind study to prove it? If the answers are yes to the first question and no to the second, then this chapter will make a lot of sense to you. Many of us in the post-operative scenario default to frozen dinners and fast food because it’s either easier to do or the only thing we are capable of doing. Once ambulatory again, fast food takes center stage because it’s easy and provides some degree of comfort. Here’s the thing; both of those inclinations, frozen and fast, are the worst possible choices to support rapid and full healing. It never occurred to me to look for a book on what to eat after spine surgery. If it had occurred to me I would have found absolutely nothing. (I will provide recipe resources for relevant sites that have a vision that is congruent with the Optimized Patient strategy.) I am thinking about a cookbook to provide recipes and a protocol for healing. This chapter doesn’t have any recipes, but it will help you to understand how to think about food that heals and in so doing help you to fire up the recovery engine…

Your health truly is your wealth. If I learned anything on this journey from the patients, doctors, physical therapists, chiropractors and nutritionists is it one thing; successfully preparing for, surviving and recovering from spine surgery is really in your control. The key ingredient is your will to get and your willingness to do the hard work of healing. Like I said in the first line of this book, if you want to get well, it’s a commitment. If you’ve made the commitment to read this book, you definitely have what it takes to be you again. The only thing that separates you from the life you are dreaming about, praying for, is your willingness to finish the job that the surgeons have started for you as an Optimized Patient.

Just as important as your surgeon, your caregiver(s) has a critical role to play in your best recovery. Your caregiver is another angle (and angel) that should not be overlooked. Your spouse, kids, brother, sister, or friends probably have as many questions and concerns as you do. I’d like to offer some insight into the caregiver side of the equation because after surgery you are going to be a whole different person when you get wheeled out of the operating room.